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VETERANS’ HEALTH CARE - Preliminary Observations on VHA’s Claims Processing Delays and Efforts to Improve the Timeliness of Payments to Community Providers
Due to increases in expenditures and utilization of VA care in the community services in recent years, VHA has had difficulty processing claims in a timely manner. In planning to consolidate its ... existing VA care in the community programs, as required by law, the agency said it will examine strategies for improving the timeliness and accuracy of its payments to community providers.<br ... /> This statement, which is based on ongoing work, summarizes GAO’s preliminary observations about (1) VHA’s, Medicare’s, and TRICARE’s claims processing timeliness in fiscal year 2015; (2) factors that have impeded ... Data processing hold back by technology limitation, workload and administrative burden ... US GAO analyzed all factors of slower processing and user unfriendliness that occur sometimes to the veterans healthcare. The main focus is data processing - and it has been proved that it can ... be failing not only because of technology, but also because of work-process design, staff and organisation.
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Due to increases in expenditures and utilization of VA care in the community services in recent years, VHA has had difficulty processing claims in a timely manner. In planning to consolidate its ... existing VA care in the community programs, as required by law, the agency said it will examine strategies for improving the timeliness and accuracy of its payments to community providers.<br ... /> This statement, which is based on ongoing work, summarizes GAO’s preliminary observations about (1) VHA’s, Medicare’s, and TRICARE’s claims processing timeliness in fiscal year 2015; (2) factors that have impeded ... Data processing hold back by technology limitation, workload and administrative burden ... US GAO analyzed all factors of slower processing and user unfriendliness that occur sometimes to the veterans healthcare. The main focus is data processing - and it has been proved that it can ... be failing not only because of technology, but also because of work-process design, staff and organisation.
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General Accountability Office
, issued in 2016
Risk cases: 6
The Shared Services Centre
The necessary environment for the efficient management of the Shared Service Center is lacking The department's administration of the Shared Services Centre (SSC) has been effective for sharing resources between the departments and delivering selected back-office services to a small client base. However, the governance arrangements established to oversight the SSC have not positioned it well for the future and the departments have not yet determined if the arrangement is efficient and resulting in savings. ANAO found instances where the advisory board of SSC was not consulted or involved in decisions relating to the strategic direction, financial arrangements and expenditure priorities. Information reported to the board did not focus on areas of strategic importance and the quality and completeness of this information could be improved. The mechanisms established for setting out responsibilities and obligations and ensuring transparency for services delivered by the SSC was weak. Service standards and levels were not fixed and can change. The delineation of responsibilities between the SSC and its clients was not clear and there was no commitment by the SSC to certify the quality of its control framework.
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The necessary environment for the efficient management of the Shared Service Center is lacking The department's administration of the Shared Services Centre (SSC) has been effective for sharing resources between the departments and delivering selected back-office services to a small client base. However, the governance arrangements established to oversight the SSC have not positioned it well for the future and the departments have not yet determined if the arrangement is efficient and resulting in savings. ANAO found instances where the advisory board of SSC was not consulted or involved in decisions relating to the strategic direction, financial arrangements and expenditure priorities. Information reported to the board did not focus on areas of strategic importance and the quality and completeness of this information could be improved. The mechanisms established for setting out responsibilities and obligations and ensuring transparency for services delivered by the SSC was weak. Service standards and levels were not fixed and can change. The delineation of responsibilities between the SSC and its clients was not clear and there was no commitment by the SSC to certify the quality of its control framework.
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The Australian National Audit Office
, issued in 2016
Risk cases: 2
RURAL BROADBAND DEPLOYMENT: Improved Consistency with Leading Practices Could Enhance Management of Loan and Grant Programs
Green Book can help in broadband development US GAO applied its COSO based Green Book to review consistency of support programs for rural information infrastructure.
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Green Book can help in broadband development US GAO applied its COSO based Green Book to review consistency of support programs for rural information infrastructure.
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US Government Accountability Office
, issued in 2017
Risk cases: 7
Information security work at nine agencies
Difficulties in achieving appropriate IT security Together with the Swedish NAO we assume that the picture that emerges at the agencies audited applies also to most of the other agencies in the public administration. The information security work is not given high enough priority in relation to the risks that exist. This applies to both the Government, which should have been clearer in its directions to agencies on this matter, and to agency managements, which did not give priority to the work of information security to the extent required. Much indicates that it is difficult for many agencies to achieve an appropriate level of information security work.
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Difficulties in achieving appropriate IT security Together with the Swedish NAO we assume that the picture that emerges at the agencies audited applies also to most of the other agencies in the public administration. The information security work is not given high enough priority in relation to the risks that exist. This applies to both the Government, which should have been clearer in its directions to agencies on this matter, and to agency managements, which did not give priority to the work of information security to the extent required. Much indicates that it is difficult for many agencies to achieve an appropriate level of information security work.
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Swedish National Audit Office
, issued in 2016
Risk cases: 4
Population registration - uphill quality work
Quality of population register The Swedish NAO notes that quality requirements for population registration are highand that quality work should concentrate on the errors that have the most seriousconsequences for society. They point then at the need to increase knowledge of the errors, improve IT tools and governance to receive more quality work.
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Quality of population register The Swedish NAO notes that quality requirements for population registration are highand that quality work should concentrate on the errors that have the most seriousconsequences for society. They point then at the need to increase knowledge of the errors, improve IT tools and governance to receive more quality work.
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Swedish National Audit Office
, issued in 2017
Risk cases: 4
Homeland Security. Oversight of Neglected Human Resources Information Technology Investment Is Needed
Human resources IT investments get stuck in management's lack of interest Although the Human Resources Information Technology (HRIT) investment was initiated about 12 years ago with the intent to consolidate, integrate, and modernize the department's human resources IT infrastructure, the Department of Homeland Security (DHS) has made very limited progress in achieving these goals. HRIT's minimally involved executive steering committee during a time when significant problems were occurring was a key factor in the lack of progress. This is particularly problematic given that the department's ability to efficiently and effectively carry out its mission is significantly hampered by its fragmented human resources. DHS's ineffective management of HRIT, such as the lack of an updated schedule and a life-cycle cost estimate, also contributed to the neglect this investment has experienced. DHS will be limited in efficiently tracking and reporting accurate, comprehensive performance and learning management data across the organization, and could risk further implementation delays.
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Human resources IT investments get stuck in management's lack of interest Although the Human Resources Information Technology (HRIT) investment was initiated about 12 years ago with the intent to consolidate, integrate, and modernize the department's human resources IT infrastructure, the Department of Homeland Security (DHS) has made very limited progress in achieving these goals. HRIT's minimally involved executive steering committee during a time when significant problems were occurring was a key factor in the lack of progress. This is particularly problematic given that the department's ability to efficiently and effectively carry out its mission is significantly hampered by its fragmented human resources. DHS's ineffective management of HRIT, such as the lack of an updated schedule and a life-cycle cost estimate, also contributed to the neglect this investment has experienced. DHS will be limited in efficiently tracking and reporting accurate, comprehensive performance and learning management data across the organization, and could risk further implementation delays.
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US Government Accountability Office
, issued in 2016
Risk cases: 1
Protection against fraud in migration activities at missions abroad
Migration activities can be a subject to fraud The audit showed that reports on alleged fraud in migration activities at missions abroad increased continually between 2014 and 2017. Altogether about 60 alleged cases of fraud were reported during the period, including selling interview appointments, stolen visa stickers, issuing visas on false grounds and prohibited searches in case management systems. Missions abroad, the Ministry for Foreign Affairs and the Swedish Migration Board are all responsible for migration activities at missions abroad. The division of responsibility between them is sometimes unclear and difficult to assess. According to the Swedish NAO this leads to particular challenges in ensuring satisfactory and common protection against fraud at missions abroad. Ensuring protection is made even more difficult in that the missions abroad vary regarding in terms of size, case volume, case mix and risk exposure. In addition, for the missions abroad the internal control requirements are notsufficiently explicit.
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Migration activities can be a subject to fraud The audit showed that reports on alleged fraud in migration activities at missions abroad increased continually between 2014 and 2017. Altogether about 60 alleged cases of fraud were reported during the period, including selling interview appointments, stolen visa stickers, issuing visas on false grounds and prohibited searches in case management systems. Missions abroad, the Ministry for Foreign Affairs and the Swedish Migration Board are all responsible for migration activities at missions abroad. The division of responsibility between them is sometimes unclear and difficult to assess. According to the Swedish NAO this leads to particular challenges in ensuring satisfactory and common protection against fraud at missions abroad. Ensuring protection is made even more difficult in that the missions abroad vary regarding in terms of size, case volume, case mix and risk exposure. In addition, for the missions abroad the internal control requirements are notsufficiently explicit.
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Swedish National Audit Office
, issued in 2018
Risk cases: 2
Coordinated Audit on Information Technology Governance
IT governance needs awareness and SAIs' support The OLACEFS auditors found that the greatest challenge for the SAIs is to raise the awareness of the audit institutions about the importance of IT governance and the benefits that could be obtained by improving its degree of maturity. The audit was conducted by 11 SAIs and coordinated by TCU of Brasil. They concluded: 'It is important, even urgent, to invest resources to implement or enhance: the IT committees; the IT planning process; strategic IT planning; monitoring the IT contracting process; the business continuity plan; the designation of a responsible person or unit to manage security information; a risk management process; an asset inventory process; an information security committee; and a policy for access control.'
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IT governance needs awareness and SAIs' support The OLACEFS auditors found that the greatest challenge for the SAIs is to raise the awareness of the audit institutions about the importance of IT governance and the benefits that could be obtained by improving its degree of maturity. The audit was conducted by 11 SAIs and coordinated by TCU of Brasil. They concluded: 'It is important, even urgent, to invest resources to implement or enhance: the IT committees; the IT planning process; strategic IT planning; monitoring the IT contracting process; the business continuity plan; the designation of a responsible person or unit to manage security information; a risk management process; an asset inventory process; an information security committee; and a policy for access control.'
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Risk cases: 5
Higher education institutions' provision of premises- room for improvement
How to pay for higher education institutions' premises Higher education institutions' rental costs constitute a significant part of central government rental expenses. Swedish NAO analysed results of reform, which aimed at more effective use of resources at central government agencies and more effective management of real property and assets for the State as a whole. Apart from the positive results as a whole, substantial room for improvement still exists: especially in identifying targets of costs, looking for incentives and in mitigating commercial approach to education institutions.
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How to pay for higher education institutions' premises Higher education institutions' rental costs constitute a significant part of central government rental expenses. Swedish NAO analysed results of reform, which aimed at more effective use of resources at central government agencies and more effective management of real property and assets for the State as a whole. Apart from the positive results as a whole, substantial room for improvement still exists: especially in identifying targets of costs, looking for incentives and in mitigating commercial approach to education institutions.
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Swedish National Audit Office
, issued in 2018
Risk cases: 2
Federal Agencies Need to Address Aging Legacy Systems
Be aware of legacy IT risks The US government spends about 75 percent of the total amount budgeted for information technology on operations and maintenance. GAO reviewed Office of Management and Budget and 26 agencies, covering years 2010 through 2017 and recommends to develop a goal for spending measure and finalize guidance to identify and prioritize legacy IT needing to be modernized or replaced.
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Be aware of legacy IT risks The US government spends about 75 percent of the total amount budgeted for information technology on operations and maintenance. GAO reviewed Office of Management and Budget and 26 agencies, covering years 2010 through 2017 and recommends to develop a goal for spending measure and finalize guidance to identify and prioritize legacy IT needing to be modernized or replaced.
Full description
General Accountability Office
, issued in 2016
Risk cases: 3